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Maryland rates for HCPCS G2083

Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.66 / $915.40 / $1,209.36
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.72 / $31.72 / $40.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.61 / $46.61 / $46.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.57 / $1,077.57 / $1,077.57
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.13 / $1,504.48 / $2,018.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.75 / $1,214.76 / $2,150.05
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.04 / $1,606.26 / $1,784.73